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General NPI Number Information
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NPI Number | 1255422705
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Entity Type | Organization
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Legal Business Name | CHS MEDICAL SUPPLY CORP
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Dates
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Enumeration Date | 09/28/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 18121 EAST EIGHT MILE RD ST 110
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City | EASTPOINTE
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State | MI
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Zip | 48021
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Country | US
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Telephone | 586-773-5329
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Fax | 586-773-5212
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Provider Business Mailing Address
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Address Line | 18121 EAST EIGHT MILE RD SUITE 110
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City | EASTPOINTE
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State | MI
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Zip | 48021
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Country | US
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Telephone | 586-773-5329
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Fax | 586-773-5212
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Authorized Official
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Title or Position | ADMINISTRATOR MANAGER
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Name | MRS. LISA LYNN LUDY
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Credential |
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Telephone | 586-773-5329
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number |
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License Number State |
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